RHSCIR Enrollment: Cumulative enrollment in RHSCIR by Canadian Province as of 09 April 2015 (N = 4818).

Access to Care and Timing: ACT Level 1 Process Mapping is expanding internationally to understand how patients with traumatic SCI are cared for along the entire care continuum across international jurisdictions. This study will highlight the importance of SCI health service research internationally to identify the “ideal attributes of SCI care” relating to patient flow and access to service. To date, we have participation from China, Saudi Arabia, Ireland, New Zealand, Australia, and India. Learn more about the ACT project.

Accreditation Standards: To date, four facilities have received site accreditation: London Health Sciences – Victoria Hospital (Acute Standards), Capital Health – Queen Elizabeth II Health Sciences Centre (Acute and Rehab Standards) and University Health – Toronto Rehab-Lyndhurst Centre (Rehab Standards). RHI spoke to accreditation teams at University Health Network and Capital to get their take on the process, how they championed the effort and why it is important to be a SCI accredited site. Read more.

Last fall, RHI teamed up with the University of Ottawa’s Faculty of Medicine program to provide a postdoctoral fellowship to a researcher primarily focused on knowledge transfer in SCI. Please welcome Dr. Justine Baron and Dr. Jeremy Grimshaw to RHI’s network. Read more.

What is your project about? The overall objective is to improve the coordination of pressure ulcer care and promote the use of evidence-informed wound treatments, including electrical stimulation therapy, for people living with SCI in the Middlesex-London Region.

What inspired you to take this on? Electrical stimulation therapy (E-Stim) is a wound treatment that involves applying low levels of electrical current to the wound bed and surrounding tissues and there is substantial research evidence to suggest it speeds the closure of pressure ulcers. Despite strong research evidence, E-Stim is NOT readily available in Canada and therefore few people with SCI who develop pressure ulcers can access this proven therapy.

How will this project help SCI clinicians in how they care for people with SCI? The educational resources and communication strategies developed during this project will be shared with clinicians working in other rehabilitation centres across Canada.

How will this project impact Canadians with SCI? By using established knowledge mobilization methods we will encourage the uptake of best practices known to improve outcomes and quality of life of people troubled with chronic, non-healing, pressure ulcers.

Who is involved in this project? This project involves the clinical expertise of a variety of health care disciplines working both in SCI rehabilitation and wound care, together with researchers who are experienced in knowledge mobilization science.

Who are the collaborating partners? It is a collaborative effort between Western University, the spinal cord injury program at Parkwood Institute, St Joseph’s Health Care London, and community partners including South West –Community Care Access Centre, and the Research Department of St. Elizabeth’s Health Care. The Rick Hansen Institute is funding this project.

Collaborators within local health care settings/agencies will participate in various steps of the study. Personnel will sit on working groups to develop a specific implementation plan that facilitates use of E-Stim in the community; health care providers working in these collaborative sites will also monitor feedback during the E-Stim program implementation and will help us strategize about ways to address barriers to E-Stim use.

What are the next steps for the project? The project officially launched on April 22nd. We are working to engage a broad audience on the purpose and nature of the study and show how this project fits into the broader mandate of pressure care for SCI across Canada.

On May 7 and 8, a two day workshop was held where providers and clinicians from collaborating sites and agencies met to develop the E-Stim plan that will then be field tested and modified based on provider and patient feedback.

Any last words…It is hoped that this is a first step in creating a national program that will improve the healing rate of people with SCI who develop pressure ulcers and prevent the high number of chronic, non-healing pressure ulcers that occur in people with SCI.

For more information about the E-Stim Collaboration, contact Dr. Houghton at .

Taking place in Montreal, Quebec in May, this Joint Meetingincluded several workshops and papers presented by Canadian SCI clinicians, researchers and patient advocates. Some highlights include:

The RHI Lecture titled ‘Understanding motor function after SCI: involvement of a defined spinal microcircuit’, presented by Robert Brownstone.

A pain workshop discussing the impact of pain on individuals participation and quality of life using data from the SCI Community Survey, presented by Luc Noreau and other interesting presentations by Catherine Mercier, Laurent Bouyer, Meyke Rossink.

A respiratory workshop featuring current practices in Canada by leading respiratory practitioners, panellists included Tova Plashkes, Jean-François Lemay, Joe Foote and Colleen O'Connell.

A workshop on emerging concepts on the pathology and clinical management of non-traumatic dysfunction caused by degenerative spinal conditions presented by Michael Fehlings, Sukhvinder Kalsi-Ryan and colleagues.

A workshop on engaging SCI consumers across the research and clinical spectrum presented by Peter Athanasopoulous, Tara Jeji and their international colleagues.

A symposium on incontinence and sexuality after SCI by Canadian experts Stacy Elliot, Mark Nigro, Anton Emmanuel and Frédérique Courtois.

A free paper on the structural and inflammatory biomarkers in cerebrospinal fluid in predicting neurologic outcomes after human spinal cord ijury, presented by Brian Kwon and statistics conducted by Nader Fallah, a biostatistician at RHI.

Two measurement papers on pressure ulcer risk, representing data from two of the six SCI Knowledge Mobilization Network sites, presented by Marie-Therese Laramee and Heather Flett.

The 3rd International Autonomic Symposium

Also in May, RHI was pleased to be a sponsor at the 3rd International Autonomic Symposium. Organized by Dr. Andrei Krassioukov, the Symposium focuses on the topic of autonomic dysfunctions that individuals with SCI and other neurological disorders face on a daily basis. The symposium gathered experts in various disciplines of medicine, basic science and the community to provide a truly multidisciplinary platform for participants to exchange ideas and learn from each other.

The PAR-QoLSpinal Cord Research Team is seeking researcher and clinician feedback on their website in this short 5-minute survey.

Alberta man breathes easier thanks to team at Foothills Medical Centre The PAR-QoLSpinal Cord Research Team is seeking researcher and clinician feedback on their website in this short 5-minute survey.

Calgary RHSCIR Site Lead Dr. Chester Ho and the team at Foothills Medical Centre successfully performed the first NeuRx Diaphragm Pacing System implant in Alberta. NeuRx DPS, developed by Synpase Biomedical Inc., is designed to assist people with spinal cord injuries who lack control of their diaphragms and are ventilator-dependent.

Funding for the NeuRx DPS was recently approved by Alberta Health Services Neuromodulation Committee. It is anticipated that the Foothills medical team will receive DPS funding support for 1-2 units per year through the support of this committee.

When the NeuRx DPS was approved for use by Health Canada in 2013, members of RHI’s national network played an instrumental role in getting the device approved.